The syndrome of interhemispheric disconnexion has been systematically researched in 10 cases of medial and posterior callosal tumours. The cases have been documented with CT Scann and two of them were anatomically verified. Two had a complete disconnexion syndrome; another, whose lesion was situated on the forceps major, had no sign of disconnexion. In the others, the semiology was proportional to the extent of the tumour, sometimes minimal and in this case, only corresponding to an extinction of the left ear in the dichotic test, which therefore appeared in our series as the most constant sign of a transfer-trouble. Among the other signs, left tactile anomia was found in two patients, left ideomotor apraxia in three, left visual anomia in five. Seven patients had a right constructional apraxia, which was bilateral in five of them. Left agraphia was noted in five patients, among which three had also a right hand dysgraphia, whose physiopathology is discussed. Tactile alexia was noted in three patients, two had a trouble of somesthesic information's transfer, one had a pure alexia (left occipital lesion plus splenium). Signs of hemispheric independence were uncommon: one patient presented a “foreign-hand sign” 1).
Osawa et al. reported two patients with tumours arising from the splenium of the corpus callosum that caused a memory disturbance consistent with retrosplenial amnesia as well as a variety of cognitive deficits including agraphia, acalculia, constructional apraxia and ideomotor and ideational apraxia involving both hands, but not aphasia. Patients showed disorientation to time and place, impaired recent memory and memorizing capacity; immediate and remote memory were preserved. Despite impaired performance intelligence quotients (IQ), verbal IQ was relatively spared. Patients also showed disconnection symptoms including bilateral crossed visuomotor ataxia and alexia to stimuli presented in the right visual field. In both cases, the tumour of the splenium had provoked surrounding oedema extending to the left parietal and occipital lobes 2).
Assencio-Ferreira et al. reported on a seven years-old boy with complex partial seizures and the presence of low grade glioma in left fronto-parietal region. The magnetic resonance imaging showed focal non-hemorrhagic lesion in the splenium of the corpus callosum. The description of the transient lesion in the splenium of the corpus callosum was related in three previous studies, in patients with epilepsy. Thus, the observed transient focal lesion in the splenium of the corpus callosum of this child, probably, has correlation with to prolonged focal partial seizures and not to the presence of glioma low grade 3).
A patient with a severe amnesic syndrome following a glioma of the splenium of the corpus callosum is reported. The long-term memory deficit involved anterograde as well as retrograde events dating back to 40 years and causing topographical disorientation. Short-term memory test performance was in the normal range, with the exception of tactile memory which was severely impaired.The patient also showed disconnection symptoms, due to severing of occipito-parietal and parieto-temporal connections, while parieto-parietal connections were undamaged 4)
1: La Rocca G, Sabatino G, Altieri R, Signorelli F, Ricciardi L, Gessi M, Della Pepa GM. Significance of H3K27M Mutation in “Nonmidline” High-Grade Gliomas of Cerebral Hemispheres. World Neurosurg. 2019 Nov;131:174-176. doi: 10.1016/j.wneu.2019.08.024. Epub 2019 Aug 12. PubMed PMID: 31415896.
2: Mohan S, Wang S, Coban G, Kural F, Chawla S, O'Rourke DM, Poptani H. Detection of occult neoplastic infiltration in the corpus callosum and prediction of overall survival in patients with glioblastoma using diffusion tensor imaging. Eur J Radiol. 2019 Mar;112:106-111. doi: 10.1016/j.ejrad.2019.01.015. Epub 2019 Jan 15. PubMed PMID: 30777198.
3: Rinaldo L, Priemer DS, Vortmeyer AO, Cohen-Gadol AA, Brat DJ, Mahajan A, Giannini C, Burns TC. Chordoma of the corpus callosum: case report. J Neurosurg. 2018 Nov 1:1-7. doi: 10.3171/2018.6.JNS181028. [Epub ahead of print] PubMed PMID: 30497142.
4: Tunthanathip T, Ratanalert S, Sae-Heng S, Oearsakul T. Butterfly Tumor of the Corpus Callosum: Clinical Characteristics, Diagnosis, and Survival Analysis. J Neurosci Rural Pract. 2017 Aug;8(Suppl 1):S57-S65. doi: 10.4103/jnrp.jnrp_176_17. PubMed PMID: 28936073; PubMed Central PMCID: PMC5602263.
5: Garber ST, Khoury L, Bell D, Schomer DF, Janku F, McCutcheon IE. Metastatic Adenoid Cystic Carcinoma Mimicking Butterfly Glioblastoma: A Rare Presentation in the Splenium of the Corpus Callosum. World Neurosurg. 2016 Nov;95:621.e13-621.e19. doi: 10.1016/j.wneu.2016.07.111. Epub 2016 Aug 10. PubMed PMID: 27521725.
6: Bruno A, Alentorn A, Daniau M, Labussière M, Rahimian A, Tabouret E, Polivka M, Jouvet A, Adam C, Figarella-Branger D, Chrétien F, Eimer S, Houillier C, Soussain C, Mokhtari K, Hoang-Xuan K. TERT promoter mutations in primary central nervous system lymphoma are associated with spatial distribution in the splenium. Acta Neuropathol. 2015 Sep;130(3):439-40. doi: 10.1007/s00401-015-1461-9. Epub 2015 Jul 21. PubMed PMID: 26195323.
7: Nazem-Zadeh MR, Chapman CH, Chenevert T, Lawrence TS, Ten Haken RK, Tsien CI, Cao Y. Response-driven imaging biomarkers for predicting radiation necrosis of the brain. Phys Med Biol. 2014 May 21;59(10):2535-47. doi: 10.1088/0031-9155/59/10/2535. Epub 2014 Apr 28. PubMed PMID: 24778364; PubMed Central PMCID: PMC4084934.
8: Beltran-Marin M, Sadeghi N. Transient restricted diffusion in the splenium of the corpus callosum after brain surgery. JBR-BTR. 2013 Mar-Apr;96(2):92. PubMed PMID: 23847833.
9: Pascual-Castroviejo I, Pascual-Pascual SI, Velazquez-Fragua R, Viaño J. [Corpus callosum tumor as the presenting symptom of neurofibromatosis type 1 in a patient and literature review]. Rev Neurol. 2012 Nov 1;55(9):528-32. Review. Spanish. PubMed PMID: 23111991.
10: Reich M, Comet B, Le Rhun E, Ramirez C. Cotard's syndrome with glioblastoma multiforme. Palliat Support Care. 2012 Jun;10(2):135-9. doi: 10.1017/S1478951511000757. Epub 2012 Feb 24. PubMed PMID: 22360815.
11: Witoonpanich P, Bamrungrak K, Jinawath A, Wongwaisayawan S, Phudhichareonrat S, Witoonpanich R. Glioblastoma multiforme at the corpus callosum with spinal leptomeningeal metastasis. Clin Neurol Neurosurg. 2011 Jun;113(5):407-10. doi: 10.1016/j.clineuro.2010.12.001. Epub 2011 Jan 3. PubMed PMID: 21208740.
12: Goh JJ, See SJ, Ang E, Ng WH. Vanishing glioblastoma after corticosteroid therapy. J Clin Neurosci. 2009 Sep;16(9):1226-8. doi: 10.1016/j.jocn.2008.10.029. Epub 2009 Jun 3. PubMed PMID: 19497751.
13: Aukema EJ, Caan MW, Oudhuis N, Majoie CB, Vos FM, Reneman L, Last BF, Grootenhuis MA, Schouten-van Meeteren AY. White matter fractional anisotropy correlates with speed of processing and motor speed in young childhood cancer survivors. Int J Radiat Oncol Biol Phys. 2009 Jul 1;74(3):837-43. doi: 10.1016/j.ijrobp.2008.08.060. Epub 2008 Dec 29. PubMed PMID: 19117694.
14: Rokutanda T, Inatomi Y, Yonehara T, Takahashi Y, Hirano T, Uchino M. [A case of glioblastoma misdiagnosed initially due to positive finding of anti-glutamate receptor antibody]. Rinsho Shinkeigaku. 2008 Jul;48(7):497-500. Japanese. PubMed PMID: 18717184.
15: Nagesh V, Tsien CI, Chenevert TL, Ross BD, Lawrence TS, Junick L, Cao Y. Radiation-induced changes in normal-appearing white matter in patients with cerebral tumors: a diffusion tensor imaging study. Int J Radiat Oncol Biol Phys. 2008 Mar 15;70(4):1002-10. doi: 10.1016/j.ijrobp.2007.08.020. PubMed PMID: 18313524; PubMed Central PMCID: PMC2376211.
18: Tamhankar MA, Coslett HB, Fisher MJ, Sutton LN, Liu GT. Alexia without agraphia following biopsy of a left thalamic tumor. Pediatr Neurol. 2004 Feb;30(2):140-2. PubMed PMID: 14984910.
19: Ishii R, Suzuki Y, Watanabe A, Mouri Y, Ishii N, Yoshii I. Gross total removal of gliomas in the pulvinar and correlative microsurgical anatomy. Neurol Med Chir (Tokyo). 2002 Dec;42(12):536-45; discussion 545-6. PubMed PMID: 12513025.
20: Palmer SL, Reddick WE, Glass JO, Gajjar A, Goloubeva O, Mulhern RK. Decline in corpus callosum volume among pediatric patients with medulloblastoma: longitudinal MR imaging study. AJNR Am J Neuroradiol. 2002 Aug;23(7):1088-94. PubMed PMID: 12169462.
21: Hancq S, De Witte O, Brotchi J. [Pineal region surgery. Experience in 22 patients]. Neurochirurgie. 2002 Feb;48(1):14-24. Review. French. PubMed PMID: 11972146.
22: Hormigo A, McCarthy M, Nothias JM, Hasegawa K, Huang W, Friedlander DR, Fischer I, Fishell G, Grumet M. Radial glial cell line C6-R integrates preferentially in adult white matter and facilitates migration of coimplanted neurons in vivo. Exp Neurol. 2001 Apr;168(2):310-22. PubMed PMID: 11259119.
23: Ideguchi M, Nishizaki T, Harada K, Kwak T, Murakami T, Ito H. Pilocytic astrocytoma of the velum interpositum. Neurol Med Chir (Tokyo). 1998 May;38(5):283-6. PubMed PMID: 9640964.
24: Yamamoto Y, Tsuji T, Suga M, Sunami N, Yamamoto Y, Kunishio K, Sonobe H. [Diffuse cerebrospinal gliomatosis. Case report]. Neurol Med Chir (Tokyo). 1991 Dec;31(13):1023-9. Japanese. PubMed PMID: 1726237.
25: Epstein MA, Zimmerman RA, Rorke LB, Sladky JT. Late-onset globoid cell leukodystrophy mimicking an infiltrating glioma. Pediatr Radiol. 1991;21(2):131-2. PubMed PMID: 2027716.
27: Bottini G, Cappa S, Geminiani G, Sterzi R. Topographic disorientation–a case report. Neuropsychologia. 1990;28(3):309-12. PubMed PMID: 2325843.
28: Sekiya T, Iwabuchi T, Suzuki S, Ohkuma H, Nonogaki Y, Hatayama T, Ogane K. [Subependymoma of the septum pellucidum. MRI features and its usefulness in planning surgery]. Neurol Med Chir (Tokyo). 1990;30(11 Spec No):874-8. Japanese. PubMed PMID: 1709468.
30: Aida T, Abe H, Iwasaki Y, Hokin K, Tsuru M. [Transcallosal approach to para-ventricular tumors]. No Shinkei Geka. 1984 Jul;12(8):943-50. Japanese. PubMed PMID: 6483101.
31: Guard O, Perenin MT, Vighetto A, Giroud M, Tommasi M, Dumas R. [Bilateral parietal syndrome approximating a Balint syndrome]. Rev Neurol (Paris). 1984;140(5):358-67. French. PubMed PMID: 6087435.
32: Ohigashi Y, Hamanaka T, Yamashita S, Tokuriki Y, Tanabe H. [Bilateral crossed visuomotor ataxia–a case report]. No To Shinkei. 1983 Dec;35(12):1217-22. Japanese. PubMed PMID: 6671073.
33: Zant JD, Collins GH, King RB, Kim RC. Recurrent intracranial hypertension and a midbrain glioma. Neurosurgery. 1982 Jul;11(1 Pt 1):68-72. PubMed PMID: 7110572.
34: Brown WJ. The capillaries in acute and subacute multiple sclerosis plaques: a morphometric analysis. Neurology. 1978 Sep;28(9 Pt 2):84-92. PubMed PMID: 568753.
35: Zatz LM, Hanbery JW, Gifford D, Belza J. The diagnosis of tumors of the splenium of the corpus callosum. Am J Roentgenol Radium Ther Nucl Med. 1967 Sep;101(1):130-40. PubMed PMID: 5298580.
36: ASZALOS Z, CSATARY Z. [Glioma of the splenium]. Ideggyogy Sz. 1960 Dec;13:353-62. Hungarian. PubMed PMID: 13684912.
37: SCHLESINGER B. Gliomas involving the splenium of the corpus callosum. Neurology. 1951 Nov-Dec;1(6):419-37. PubMed PMID: 14899584.
38: SCHLESINGER B. Gliomas involving the splenium of the corpus callosum; a roentgenologic study. J Neurosurg. 1950 Jul;7(4):357-63. PubMed PMID: 15422403.